Anthem I MaineHealth Advantage Choice (HMO-POS)

3.5 out of 5 stars
$55.00
Monthly Premium

Anthem I MaineHealth Advantage Choice (HMO-POS) is a HMO-POS plan offered by Anthem Inc.

Plan ID: H9065-003

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.


Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.

Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.

Learn more about Medicare Advantage plans such as Anthem I MaineHealth Advantage Choice (HMO-POS) - H9065-003 by Anthem Inc. as well as other Medicare Advantage plans available in your area.

$55.00
Monthly Premium

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $150
Out of Pocket Max In-Network: $7550
Out-of-Network: 13900
Initial Coverage Limit $0
Catastrophic Coverage Limit $2100
Primary Care Doctor Visit
In-Network:
$0.00 copay
Specialty Doctor Visit

Out-of-Network:
$75.00 copay
Inpatient Hospital Care
In-Network:
Days 1-6: $395.00 per day, per admission / Days 7-90: $0.00 per day, per admission
Urgent Care
Urgent Care: $40.00 copay
Emergency Room Visit
Emergency Care: $115.00 copay
Worldwide Coverage: This plan covers urgent care and emergency services, including emergency transportation, when traveling outside of the United States for less than six months. This benefit is limited to $100,000 per year.
Ambulance Transportation
Ground Ambulance: $325.00 copay Per Trip
Air Ambulance: $325.00 copay

Health Care Services and Medical Supplies

Anthem I MaineHealth Advantage Choice (HMO-POS) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Coverage Cost
Chiropractic Services
In-Network:
Medicare Covered Chiropractic Services: $15.00 copayOut-of-Network:
Medicare Covered Chiropractic Services: 30% coinsurance
Diabetes Supplies, Training, Nutrition Therapy and Monitoring

Out-of-Network:
30% coinsurance
Durable Medical Equipment (DME)

Out-of-Network:
30% coinsurance
Diagnostic Tests, Lab and Radiology Services, and X-Rays
In-Network:
Lab Services: $0.00 copay - $10.00 copay
X-Rays: $35.00 copay - $70.00 copay
Therapeutic Radiological Services: 20% coinsurance
Outpatient Diagnostic Procedures/Tests: $0.00 copay - $70.00 copay
Diagnostic Radiological Services: $35.00 copay - $395.00 copay
Home Health Care
In-Network:
$0.00 copay
Mental Health Inpatient Care
In-Network:
Days 1-5: $395.00 per day, per admission / Days 6-90: $0.00 per day, per admission
Mental Health Outpatient Care

Out-of-Network:
30% coinsurance
Outpatient Services / Surgery
In-Network:
Outpatient Hospital - Surgery: $395.00 copay
Observation Services: $395.00 copay
Ambulatory Surgical Center: $395.00 copay
Outpatient Substance Abuse Care
In-Network:
Individual and Group Sessions: $45.00 copay
Out-of-Network:
30% coinsurance
Over-the-counter (OTC) Items
This plan covers certain approved, non-prescription, over-the-counter drugs and health-related items, up to $35 every quarter. Unused OTC amounts expire at the end of each quarter.
Podiatry Services
In-Network:
Medicare Covered Podiatry Services: $0.00 copay - $45.00 copay
Routine Foot Care: $0.00 copay
6 routine foot care visit(s) each year.
Out-of-Network:
Medicare Covered Podiatry Services: $75.00 copay
Skilled Nursing Facility Care
In-Network:
Days 1 - 20: $0.00 per day / Days 21 - 100: $218.00 per day

Dental Benefits

The following dental services are covered from in-network providers.

Coverage Cost
Dental Care
In-Network and POS(Out-of-Network)



In-Network

Medicare Covered Dental: $0.00 copay

Vision Benefits

The following vision services are covered from in-network providers.

Coverage Cost
Vision Benefits
In-Network:
Medicare Covered Eye Exam: $0.00 copay - $45.00 copay
Routine Eye Exam: $0.00 copay
This plan covers 1 routine eye exam(s) every year.
Medicare Covered Eye Wear: 20% coinsurance
Routine Eye Wear: $0.00 copay
This plan covers up to $125 for eyeglasses or contact lenses every year.

Hearing Benefits

The following hearing services are covered from in-network providers.

Coverage Cost
Hearing Benefits

Out-of-Network:
Medicare Covered Hearing Exam: $75.00 copay

Preventive Services and Health/Wellness Education Programs

The following services are covered from in-network providers.

Coverage Cost
Preventive Services and Health/Wellness Education Programs

Out-of-Network:
20% coinsurance

Prescription Drug Costs and Coverage

The Anthem I MaineHealth Advantage Choice (HMO-POS) plan offers the following prescription drug coverage, with an annual drug deductible of $150 (excludes Tiers 1, 2 and 6) per year.

Coverage Cost
Coverage & Cost
Annual Drug Deductible $150 (excludes Tiers 1, 2 and 6)
Preferred Generic
  • Standard retail $5.00
  • Standard mail order $0.00
  • Preferred cost-share retail $0.00
Generic
  • Standard retail $7.00
  • Standard mail order $0.00
  • Preferred cost-share retail $0.00
Select Care Drugs
  • Standard retail $0.00
  • Standard mail order $0.00
  • Preferred cost-share retail $0.00
Annual Drug Deductible $150 (excludes Tiers 1, 2 and 6)
Preferred Generic
  • Standard retail $10.00
  • Standard mail order $0.00
  • Preferred cost-share retail $0.00
Generic
  • Standard retail $14.00
  • Standard mail order $0.00
  • Preferred cost-share retail $0.00
Select Care Drugs
  • Standard retail $0.00
  • Standard mail order $0.00
  • Preferred cost-share retail $0.00
Annual Drug Deductible $150 (excludes Tiers 1, 2 and 6)
Preferred Generic
  • Standard retail $15.00
  • Standard mail order $0.00
  • Preferred cost-share retail $0.00
Generic
  • Standard retail $21.00
  • Standard mail order $0.00
  • Preferred cost-share retail $0.00
Select Care Drugs
  • Standard retail $0.00
  • Standard mail order $0.00
  • Preferred cost-share retail $0.00
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